Abstract
Introduction: Fractional CO2-laser is considered a preferential method for skin resurfacing, but little is known about the molecular mechanisms underlying this surgical tool. In the present ...study, we investigated the possible role of apoptosis by the sequential analysis of lesional skin after laser treatment, with special attention to power. Moreover, we have analyzed if there is a correlation with clinical improvement. Materials and methods: We evaluated the effects of fractional CO2-laser in twelve patients with photodamage skin Fitzpatrick types I to III. Apoptosis markers were assessed by an immunohistochemical study on skin samples of foream at 24 h, 72 h and 7 days after the irradiation with 15 W or 20 W. Moreover, clinical improvement was assessed by iconography. Results: Fractional CO2-laser induced an inflammatory repair process mediated by activation of apoptotic pathway that was completed in 7 days. The expression of proapototic markers, as annexin-VII and Caspases-9 was increased 24–72 hours after irradiation and decreased after 7 days. While the expression of the anti-apototic marker Bcl-2 increased progressively during 7 days after treatment. Conclusion: Our study suggests that the skin's appearance may be enhanced by creating skin changes through apoptosis. Apoptosis, one of the major mechanisms of cell death, might play a key role in initiating the paracrine cascades that lead to cell proliferation.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
Inflammatory linear verrucous epidermal nevus (ILVEN) is a benign cutaneous hamartoma, and more precisely an uncommon variant of the verrucous epidermal nevus. In our case report we describe ...an ILVEN female patient, resistant to previous treatments but responsive to a combined laser therapy, 10,600-nm CO2 laser and Fractional CO2 laser, with good and longstanding results. A complete resolution of the lesion was observed at the 9-month follow-up. The application of lasers has been reported in literature over recent years for resolving ILVEN lesions. Based on our clinical experience, 10,600-nm CO2 pulsed laser therapy seems to be the best treatment and Fractional CO2 laser treatment can be regarded as a very promising technique to combine with CO2 laser for reducing pigment modifications and endowing a more youthful appearance to the treated areas.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Summary
Background Fractional resurfacing is a laser treatment modality to create numerous microscopic thermal injury zones of controlled width, depth, and density that are surrounded by a reservoir ...of spared epidermal and dermal tissue, allowing rapid repair of laser‐induced thermal injury.
Objective To evaluate the safety and efficacy of a fractional CO2 laser system in the treatment of photo‐damaged skin with clinical, histological, and ultrastructural evaluation, with special attention to one of the parameters of this laser system: the fluences.
Materials and methods Twelve patients with Fitzpatrick skin types II to III with photo‐damage skin underwent fractional laser treatment with one single‐pass superficial on the face and forearm. Clinical outcome and histological and ultrastructural changes were assessed.
Results Light microscopy of biopsies gave important information about skin changes at three different times after fractional treatment, especially revealing some differences between the fluences used in the three groups of patients.
Conclusion Fractional resurfacing offers significant surgical advantages allowing to achieve excellent esthetic results in balance with the biological structure. Besides, our study shows already that with 2.07 and 2.77 J/cm2, instead of 4.15 J/cm2, it is possible to reach a biological response without scar formation.
Jassner–Kanof disease is a benign cutaneous disorder clinically characterized by recurrent asymptomatic erythematous papules and plaques sometimes grouped with an arciform disposition on the face, ...neck, and back. We describe a case of Jassner–Kanof disease resistant to conventional therapy, in which the lesions located on the arms were treated with 595 nm pulsed dye laser, and those on the trunk underwent a treatment with tacrolimus 0.03% ointment. We have compared the results and the potential side effects with the two treatments, and after 1 year of follow‐up, no recurrence of cutaneous lesions were observed.
Recently, it has been developed a new technology for the reduction of subcutaneous adipose tissue through a non-invasive treatment by microwaves. The main objective of the present study is to ...demonstrate the feasibility of utilising a non-invasive, localised microwaves (MW) device to induce thermal modifications into subcutaneous adipose tissue only by a controlled electromagnetic field that heats up fat preferentially. This device is provided with a special handpiece appropriately cooled, directly contacting the cutaneous surface of the body, which provides a calibrated energy transfer by microwaves.
In this paper, microscopic and ultrastructural modifications of subcutaneous adipose tissue induced by microwaves irradiation are evaluated.
Our experimental plan was designed for collecting biopsy samples, for each skin region treated with a single irradiation session, 1) before treatment (control), 2) immediately after treatment, 3) after 6 hrs, 4) after 1 month, 5) after 2 months. Bioptic samples from each step were processed for light microscopy and transmission electron microscopy. At the same time, each region where biopsies were collected was subjected to ultrasound examination. Recorded images permitted to evaluate the thickness of different layers as epidermis, dermis, hypodermis, connective fasciae, until to muscle layer, and related modifications induced by treatment.
In every biopsy collected at different time-steps, epidermis and superficial dermis appeared not modified compared to control. Differently, already in the short-term biopsies, in the deep dermis and superficial hypodermis, fibrillar connective tissue appeared modified, showing reduction and fragmentation of interlobular collagen septa. The most important adipose tissue modifications were detectable following 1 month from treatment, with a significant reduction of subcutaneous fat, participating both the lysis of many adipocytes and the related phagocytic action of monocytes/macrophages on residuals of compromised structures of adipocytes. In the samples collected two months following treatment, the remnants of adipose tissue appeared normal, and macrophages were completely absent.
Ultrasound, microscopic and ultrastructural evidence are supporting significant effectiveness of the new device treatment in the reduction of subcutaneous fat. In this paper, the possible mechanisms involved in the activation of the monocytes/macrophages system responsible for the removal of adipocytes residuals have also been discussed.
The CO 2 laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous wave ...CO 2 laser delivery system and the newer “superpulsed” and scanned CO 2 systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO 2 laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital.
The CO.sub.2 laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous ...wave CO.sub.2 laser delivery system and the newer "superpulsed" and scanned CO.sub.2 systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO.sub.2 laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital.
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